What is Lazanda?

Lazanda nasal spray is used to treat "breakthrough" cancer pain. It is taken together with other non-fentanyl narcotic pain medicine that is used around the clock. This medication is not for treating pain that isn't cancer-related, such as pain from surgery, dental work, or migraine headaches.

Unless given in a hospital, Lazanda is available use only under a special program. You must be registered in the program and understand the risks and benefits of taking this medication.

Lazanda nasal spray may also be used for purposes not listed in this medication guide.

Important information

Do not use Lazanda unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Do not use Lazanda to replace any other form of fentanyl. If you switch from another form of fentanyl, you will not use the same dose.

Fentanyl can slow or stop your breathing. Never use Lazanda in larger amounts, or for longer than prescribed. Fentanyl may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Slideshow: 2014 Update - First Time Brand-to-Generic Switches

Lazanda is not for treating pain that isn't cancer-related, such as pain from surgery, dental work, or migraine headaches. MISUSE OF NARCOTIC PAIN MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription

Many other drugs can interact with fentanyl. Tell your doctor about all your medications and any you start or stop using during treatment with Lazanda.

Keep this medicine out of the reach of children. The amount of fentanyl in each bottle of Lazanda can be fatal to a child.

Unless given in a hospital, Lazanda is available use only under a special program that you must be registered in.

Before using Lazanda

Do not use Lazanda unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.

Tell your doctor if there are children living in the home where you will store this medicine. Keep out of the reach of children. The amount of fentanyl in Lazanda can be fatal to a child.

To make sure Lazanda is safe for you, tell your doctor if you have:

any type of breathing problem or lung disease;

a history of head injury, brain tumor, or seizures;

a history of drug abuse, alcohol addiction, or mental illness;

urination problems;

liver or kidney disease;

a blockage in your stomach or intestines;

problems with your gallbladder, pancreas, or thyroid.

Fentanyl is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

FDA pregnancy category C. It is not known whether this medicine will harm an unborn baby. Fentanyl may cause breathing problems, behavior changes, or life-threatening addiction and withdrawal symptoms in your newborn if you use the medication during pregnancy. Tell your doctor if you are pregnant.

Fentanyl may also cause drowsiness, breathing problems, or addiction and withdrawal symptoms in a nursing infant. Do not breast-feed while you are taking Lazanda.

Do not give this medication to anyone under 18 years old.

How should I use Lazanda?

Do not use Lazanda to replace any other form of fentanyl, such as Abstral, Actiq, Fentora, Onsolis, Duragesic, or generic brands of fentanyl (injection, skin patch, dissolving film, or "lollipop" device).

Fentanyl may be habit-forming, even at regular doses. Never share this medicine with another person. MISUSE OF NARCOTIC PAIN MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away Lazanda nasal spray to any other person is against the law.

Follow all directions on your prescription label. Fentanyl can slow or stop your breathing. Never use Lazanda in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Keep using your around-the-clock narcotic pain medicine but never use Lazanda together with a second form of fentanyl.

If you switch to Lazanda from another form of fentanyl, you will not use the same dose. You must start with the lowest dose (100 micrograms).

The usual starting dose is 1 single spray into 1 nostril. Your doctor may change your dose to make sure you get the best results. Follow dosing instructions very carefully. Do not use more than one dose for each episode of breakthrough cancer pain.

Call your doctor if you still have pain within 30 minutes after using the nasal spray. Do not use the nasal spray more than 4 times in 24 hours. You must wait at least 2 hours after your last dose of Lazanda before you can treat a new pain episode.

Do not treat more than 4 pain episodes per day with Lazanda. Call your doctor if you have breakthrough pain more than 4 times in one day.

Do not stop using Lazanda suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using this medicine.

Keep out of the reach of children. The amount of fentanyl in each bottle of Lazanda can be fatal to a child.

Do not use a bottle of Lazanda that has not been used for 5 days or longer. Once you have primed a spray bottle, throw it away after 14 days, even if there is still medicine left in it.

Store at room temperature, away from heat and moisture. Keep the bottle tightly closed and stored in the child-resistant container when not in use.

Keep track of the amount of medicine used from each carton. Fentanyl is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since Lazanda is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A fentanyl overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include extreme drowsiness, weak pulse, fainting, and slow breathing (breathing may stop).

What should I avoid?

Fentanyl may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid using a decongestant nasal spray while you are using Lazanda.

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with fentanyl. Check your food and medicine labels to be sure these products do not contain alcohol.

Grapefruit and grapefruit juice may interact with fentanyl and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

Lazanda side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Lazanda: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Lazanda and call your doctor at once if you have:

slow heart rate, weak or shallow breathing, sighing;

confusion, extreme fear, unusual thoughts or behavior; or

feeling like you might pass out.

Common Lazanda side effects may include:

nausea, vomiting, constipation; or

fever.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Lazanda?

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking Lazanda with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with fentanyl. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment, especially:

This list is not complete and many other drugs can interact with fentanyl. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Related treatment guides

Where can I get more information?

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lazanda only for the indication prescribed.

Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.